Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.12 / $71.12 / $103.71	Facility	26	$71.12	$71.12	$103.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.72 / $136.79 / $264.20	Professional		$105.72	$136.79	$264.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.17 / $61.60 / $103.71	Professional	26	$52.17	$61.60	$103.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.11 / $66.77 / $165.23	Professional	TC	$53.11	$66.77	$165.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.01 / $56.01 / $56.01	Professional	26	$56.01	$56.01	$56.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.30 / $199.81 / $360.94	Professional		$114.30	$199.81	$360.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.37 / $81.01 / $154.37	Professional	26	$49.37	$81.01	$154.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.90 / $125.87 / $211.22	Professional	TC	$55.90	$125.87	$211.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $131.55 / $175.48 / $360.45	Professional		$131.55	$175.48	$360.45
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.78 / $85.17 / $174.76	Professional	26	$63.78	$85.17	$174.76
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.77 / $90.31 / $185.69	Professional	TC	$67.77	$90.31	$185.69
Horizon BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $107.73 / $197.11	Professional		$75.00	$107.73	$197.11
Horizon BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.10 / $56.59 / $113.18	Professional	26	$48.10	$56.59	$113.18
Horizon BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.75 / $60.88 / $140.56	Professional	TC	$51.75	$60.88	$140.56
United Facility/Professional Professional Modifier Low / Median / High Price $93.76 / $148.77 / $267.63	Professional		$93.76	$148.77	$267.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.51 / $66.56 / $119.00	Professional	26	$45.51	$66.56	$119.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.46 / $76.95 / $152.97	Professional	TC	$44.46	$76.95	$152.97